Intrauterine herpes simplex virus infections

Area of Science:

• Virology
• Neonatalogy
• Obstetrics

Background:

• Neonatal herpes simplex virus (HSV) infection is typically acquired during birth.
• Some cases suggest intrauterine acquisition of HSV, leading to congenital malformations.

Purpose of the Study:

• To describe the clinical manifestations and outcomes of intrauterine HSV infection in a cohort of infants.
• To investigate the association between maternal HSV infection (primary or recurrent) and congenital HSV infection.

Main Methods:

• Case series describing 13 infants with clinical evidence of intrauterine HSV infection.
• Diagnosis confirmed by viral isolation of HSV-2 in all cases.
• Maternal history of genital HSV infection was assessed.

Main Results:

• All 13 infants presented with combinations of defects including skin lesions, scars, microcephaly, hydranencephaly, microphthalmia, and chorioretinitis.
• HSV-2 was isolated from all infants.
• Two infants died within the first week; survivors experienced severe neurologic sequelae or blindness.
• Maternal infections included primary (4) and recurrent (1) HSV, with some mothers asymptomatic.

Conclusions:

• Intrauterine HSV infection can occur due to primary or recurrent maternal HSV infection.
• Congenital HSV infection results in severe fetal abnormalities and significant neonatal morbidity and mortality.
• Early identification and management of maternal HSV are crucial to prevent severe congenital outcomes.